Pontifical Catholic University of Campinas (PUC-Campinas), Postgraduate Program in Health Sciences, Campinas, SP Brazil.
School of Public Health, University of Sao Paulo, Sao Paulo, SP Brazil.
J Public Health (Oxf). 2023 Mar 14;45(1):e7-e9. doi: 10.1093/pubmed/fdab398.
To evaluate excess mortality in Brazil from January 2020 to April 2021, according to the primary causes of death registered in the Brazilian Mortality Information System (MIS).
Cross-sectional study with data extracted from the MIS. Excess deaths were examined by the primary cause of death according to 11 grouped causes. Autoregressive models used mortality data from 2015 to 2019 to predict expected deaths from January 2020 to April 2021. Excess deaths were calculated as the difference between the observed and the expected number of deaths.
Total excess deaths of 370 055 were observed in the studied period, corresponding to a ratio of observed to expected of 1.14 in 2020 and 1.40 in 2021. Excess deaths were seen in three groups: symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified; other diseases of the respiratory system and coronavirus infection, unspecified site.
The excess mortality in Brazil in these 16 months was 1.20 times greater than the previous year. The increase in not elsewhere classified causes and causes of death associated to COVID-19 indicate caution about the negative balance for some causes. Furthermore, the inequalities of mortality reporting systems in low- and middle-income countries in relation to underestimation of mortality still need to be addressed.
根据巴西死亡信息系统（MIS）登记的主要死因，评估 2020 年 1 月至 2021 年 4 月巴西的超额死亡率。
这是一项使用从 MIS 提取的数据进行的横断面研究。根据 11 个分组死因，通过主要死因检查超额死亡。自回归模型使用 2015 年至 2019 年的死亡率数据来预测 2020 年 1 月至 2021 年 4 月的预期死亡人数。超额死亡人数被计算为观察到的死亡人数与预期死亡人数之间的差异。
在研究期间观察到总超额死亡人数为 370 055 人，2020 年观察到的死亡人数与预期死亡人数的比例为 1.14，2021 年为 1.40。超额死亡人数出现在三个组中：未在其他地方分类的症状、体征和异常临床及实验室检查结果；未在其他地方分类的其他呼吸系统疾病和冠状病毒感染，部位未特指。
在这 16 个月中，巴西的超额死亡率比前一年高出 1.20 倍。未在其他地方分类的原因和与 COVID-19 相关的死因的增加表明，需要对一些原因的负平衡保持警惕。此外，还需要解决中低收入国家死亡率报告系统中对死亡率的低估导致的不平等问题。
